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12218 SW HOLLOW LANE F f e 12218 SW HOLLOW LN .�. \ CITY OF TIGARD MECHANICAL PERMIT DEVELOPMENTSERVICES PrERM11 #: MEC2004-00152 13125 SW Hall Blvd., Tigard, OR 97223 (503) 630-4171 DATE= ISSUED: 3/26/04 PARCEL: 2S103CB-11800 SITE ADDRESS: 12218 SW HOLLOW LN SUBDIVISION: QUAIL HOLLOW - EAST Z(.,v;NG R-4.5 BLOCK: LOT:076 JURISDICTION: TIG CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS: TYPE OF USE: SF UNIT HEATERS: VENT FANS: OCCUPANCY GRP: VENTS W/0 APPL: VENT SYSTEMS: STORIES: BOILERS/COMPRESSORSHOODS: FUEL_ T_Y_PES_ 0 - 3 HP: _ DCMES. INCIN: 3 - 15 HP: CUMML INCIN: MAX INPUT: BTU 15 - 30 HP: FIRE f1AMPFRS?: 30 - 50 HP: REPAIR S: CAS PRESSURE: 50 + HP: C ODSTOVEVES: FURN < 100K BTU: AIR HANDLING UNITS CLO DRYERS: OTHER UNITS: 1 FURN >=100K BTU: <= 10000 cfm: VAS OUTLETS: > 10000 cfin: Remarks: Inslull r.Xtcrwr 21 ( . DO nut I)larr kN itlun tltc rcytutr(l tirtharks Owner- _ _---FEES JULIE SMITH Description Date Amount 12218 SW HOLOW LANE \I I l I I not Per 3/26/04 $72.50 1 \\I Y „ ~tate Sul(11,11! 3/26/04 $5.80 Phune. 50 :": 1533 Total $7&,30 Contractor: SPE(-;AL FY HEATING & COOLING 1601 SE RIVER RD HILLSBORO, OR 97123 Rr'OUI<ED INSPECTIONS Phone. �().;-640-36(17 Final Inspection Rey #: LIC 66578 T his permit is issued subject lo the regulations contained in the Tigard Municipal Code, State of Ore. Specialty Codes and all other applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issua,ice, or if work is suspendec for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted in the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0100. You may obtain copies of these rules or direct questions to OUNC by calling (503)246-6699. Issued By: _ ; i i_ - 1 _ Permittee Signature: Cull (503) 639-4175 by 7:00 P.M. fog inspections needed the next business day USE NLY Me1'.'illapiCai _Permit A,j� Aica1iQD FOR OFFICE a Rrcci�cd �tcchanival _ ( Detr/sy_ `=;�'YY1 Pei nirNo.�G (City of Tigard and �i`-� Planning Approval Building — `� Date/By! Permit No.: 11125 iW Hnll Blvd. Plan Review Other Tigard,Ore@ on 97223 DattaMy. Permit No. Phone: 503-S39-4171 Fax: 503-598-1960 Post-Review Land Use Date/By _Case No.: Interne,: WN W.Cl.tlgald.oL.t1a ConmCl luras,; 29 5cr Page 2 for 24-hou:Inspection Request: 503-639-4175 l Narro/Mothnd: _ 5ur�cmental lnfurrnniien. -TYPE OF WOW - �, v COMMAUAL,VEX*SCKEDULE-USE CIIECKL1ST ❑New eo lstruction I D Demolition Mechanical permit fees"are based on the total value of the work Additiol l/alter^tion/replaccment I D Other: performed, In6cate the value(rounded to the nearest dollar)of all 'CATEGORY Or CONSTRUCT-ION, <� riiecha.nical motorials,equipment,labor,overhead and profit, 1 5t:2-:F imily dwelling al/Industrial Value: S Sec Page s for Fee Schedule ACCCS:C ry 13ttildinp ` D Multi-Family "IDENiZA>uE IvIENTISYSTEMS FEE'SCMULE ' Deat:ri tivn Cat oa, Totd [,M¢.ster-.3uilder T 0 Other tin cneung tJ0_;3.S1TE INFOItM�TION.duilZbGA'LCON Furnace•add-on tr con i[ionin • 14.00 Job site ad(ret s: I L l k ;? k (,.w) rna heat pump Suite #: BIdg•/Apt•#: Duct work 14.00 Project Nat ne: H dronic hot waters stem 14,00 i-- — - — Residential boiler Cross stree/Directions to Job site: for radiator or hydromc system) 14.00 Unit heaters(fuel,not electric) in wall,in-duct,suspended,etc, 14.00 Flue/veal fui tuiy of above) 10.00 Repair units 12,15 Subdi;isioll: Lot#; -- - - Other Fuel Awillancas Tax rr t/rircel #: Wwter heater _ 1 10.00 tI)ESWPTION OP KQI?.K_ :''• Cas fireplace _ 10.00 Flue vent(water heater/ as flit lace) 10.00 Log lighter as y 10.00 Wood/Pellet stove 0.00 Wood fireplace/insert 10.00 Chitnney/lincr/flue/vent 10.00 PR()PER TY OWNER TENANT Other: _ 10,00 C, t`- Environmental Exhalist St Ventilation Nair=-» s- A e3 �4 --- Rangc hood/other kitchen equipment 10.00 Addwss: _ +-^-L _ Clothes dryer exhauat 1.0.00 Cit /atate'Zip: Single duct exhaust Phone! -L-1 f�3FFa), .» rte_ (bathrooms,toilet compartments, Y`LI(_,t1V'f I L1OIQAGT-PER.'IOlV.'! �' unli rooms 6 NIl<tut.: Q- f ,80 Attic/crawls ace fans 10,00 — — Address: Other: —� _ Fuel Piping Clt / hate/Zip: '_(SS 40 for nrst_f4,'$1.00 each additional Phon _ Fax: _ Furnace,etc. •` — Gas heat pump E-Mail: _ Walitsus ended/unit heater '• � CONTRACTOR. `.Vater heater — •` $uS1IICSS Jame: - �� r.l '\e Fere lace r` Addr;sS: Ra" e — ,r BB rr City/State/Zip: 1{1 f(S _.�s"r-�? c� }1 T Clothes dryer as '• Phone: L_L(u Wit: e Fax: `i,3 OthU. V _ " CCB L'ic. #: ��{ J Total: ,qutholiZed Heehanic>*l Permit Fcaa' 1 C t_� _ L' C.' Subtotal; $ 51snaturc: 16�r �- _ 17ate: _ Minimum Perini[fee S'2.50 S `�.� L'` 0 1 �''-x I Plan Review Fct:(2S`.'o of Permit Fcc S —""l (Please print name) State Surcharge(8%of Pcrmit Fee) f t� TOTAI.PIiRMrr FEE S 1 Nottol: This tcrink application expire,ifs permit is not obtained"ithin 'Fcc methodology set by TH-County Building Industry Service Board. no dap+ane it hits been steepled as complete_ '*Site plain required for exterior.VC units. i\DsLWcmdt Forn%%\MecPem itApp.dor 01/03 Z ' 8 I L_O BBS COS 2x.1 1 zeaH Rz 1 e t 0009 d i O t CO 60 Sr? aQW .,SITE PLAN P1- N / 1 --f]k J r t� PL (21 STREET Specialty Heating & Cooling, Inc. 9528 SW Tigard Street Tigard, OR 97223 Phone 503.620.5643 Fax 503.598.07 i 8 Hillsboro Phone 503.640-3607 Fax 503 .681 .0793 E: HILO ass FOS 9u1ze0H 9g1etoadg dTO :EO 4th „ aeW CITY OF TIGARD _ ELECTRICAL PERMIT ® / ^PERMIT#: ELC2004-00154 DEVELOPMENT SERVICES DATE ISSUED: 3/26/04 13125 SW Hall Blvd., Tiqard, OR 97223 (503) 639-4171 PARCEL: 2S103CB-11800 SITE ADDRESS: 12218 SW HOLLOW LN ZONING: R-4.5 SUBDIVISION: QUAIL HOLLOW-EAST BLOCK: LOT : 076 JURISDICTION: TIG Project Description: Job No.2659 A/C and plug RESIDENTIAL UNIT TEMP SR_VC/FEEDERS _ _ MISCELLANEOUS 1000 SF OR LESS: 0 200 amp �PUMPIIRRIGATION: EACH ADD'L 500SF: 201 - 400 amp: SIGN/OUT LINE LTG: LIMITED ENERGY: 401 - 600 amp: SIGNALIPANEL: MA.NF HM/SVC/FDR: 601+amps - 1000 volts: MINOR LABEL (10): SERVICE/FEEDER BRANCH CIRCUITS ADD'L INSPECTIONS 0 - 200 amp: W/SERVICE OR FEEDER: PER INSPECTION: 20' - 400 amp 1st WIO SRVC OR FDR: 1 PER HOUR: 401 - 600 amp: EA ADD'L BRNCH CIRC: 1 IN PLANT: 601 - 1000 amp PLAN REVIEW SECTION 1000+ amp/volt: >=4 RES UNITS: > 600 VOLT NOMINAL: Reconnect only: _ SVC/FDR>=22.5 AMPS: _ CLASS AREA/SPEC OCC: Owner: Contractor: JULIE SMITH HILLSBORO ELECTRIC 12218 SW HOLOW LANE 21185 NW EVERGREEN PARKWAY HILLSBORO,OR 97124 Phone: 503-579-45b3 Phone: 503-435-9666 Reg #: ELF, 34-43990 -- LIC 134461 FEES_ SUP 49415 Description Date Amount _ Required Inspections (ELPRMTI EL.0 Permit 1 'r, n4 $53 50 (TAX]80%State Surcharge 20 ii-t $4,28 Elect')Final Total $57.78 This Permit is issued subject to the regulations contained in the Tigard Municipal Code.State of OR Specialty Codes and all other applicable laws. All work will be done in accordance with approved pians. This permit will expire if work is not started within 180 days of issuance.or I work is suspended for more than 180 days. ATTENTION Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0100. You may obtain copies of these rules or direct questions to OUNC at(503) 2466699 or 1-800-332-2344. Issued By: Permit Signature: OWNER INSTALLATION ONLY I l w installation is being made on property I own which is not intended for sale, lease, or rent. OWNER'S SIGNATURE: DATE: CONTRACTOR INSTALLATION ONLY SIGNATURE OF SUPR. ELEC'N: __-_� ___ ____._ ___ _ DATE: I_I C E N S E N O: Call 639-4175 by 7:00pm for an inspection the n . business day F r W H I LLS60R0 ELECTRIC LLC. 5036013680 03/25/2004 15:58 #347 P.002 iectrical Permit Application City of Tigard "Im" vermis No. -A, 5c�` 136 SW Hall Blvd.,Tigard,OR 97223 Ian Review Phone. 503.639.4171 Far: 503.598 1960 pOther Permit. Inspection Line, 503.639.4175 Data Rwdy� y - anis' d Sw Pa�e2 far Internet, www,ci,14sord.or.us Nonfied/Method _Sappismeetoi trformstton TYPE OF WORK - �- PLAN REVIEW T----_ r❑New construction Addition/alteration/rept4cement Please cheok all that apply: Demolition [1 Other: -� ❑Service over 225 amps,comm'I ❑Narardous location []Service over 310 amps-rating DBuildng over 10,000 sq.it, CATEGORY OF CONSTRUCTION of 1•and 2-family dwellings 4 or more new residential i-and 2-family dwelling Commerciallindustrial Accessory building []System over 600 volts nominal units in one structure Ll Multl•famil Master builder ❑Other: ❑building over three stories LJ Feeders,400 amps or more — 00coupant toad over 99 persons ❑Manufactured structures or JOB SiTE INFORMATION AND LOCATION ❑Egress/lightingplan RV perk Job no. Job site address: 01-In4h•care fUllity ❑Other: Submit_,sets of plans with any of the above. sty/StdteJZlp. -n 2, iThe above aro not applicable to temporary constmetion service, Suhdbidg./apt,no.: / Project name: FEE"`.SCHEDULE, "`.. tMsstipllon lJly. Fat Toto Cross street/directions to job site: New residential single-or multl-family dwelling unit Includes attached garage. 1,000 sq.R.or las 145.15 4 Subdivision: Lot no.: 8o,add'I 500 ,R or portion 33,40 1 Tax map/parcel no.: — LlmitcJ over ,residential 75.00 2 _ Limited energy,non-residential 7!1,00 2 DESCRIPTION OF WORK Each m anuflictured or modular K T, / �� t^ '� �t ! Services es orfeice and/or t1lotlaader 90,90 _ f/U U li �(/ •�[•'� ,l.f��_ $ervica or feeders inalaliatbn,aitentlon,and/or rrlocaUan 200 amps or less _- 80.30 2 PROPERTY OWNEW U TENANT 101 amps to 400 am 106.15 2 o ------ 401 amps to 600 amps 160.60 2 Name: v _ 601 amps to 1,000 am 210.60 2 Address: 1 �L� Over t,000 am or volts 454.65 2 -._-- -- Reconnect onlz 66.85 2 CiryiSteidZiP: Temporary servka or hales installation,alteration,and/or Phone: ) Fax:( ) treMti n _ 200 amps or less 66.85 1 Owner installations This installation is being made on property that I own which is not 201 amps to 400 amps 100,30 2 Intended for sale,lease,rent,of exchange,according to ORS 447,439,670,and 701. 401 am ps to 600 amps 133.75 2 Owner signature: Date: Branch circuits-new,alteration,or extension,per panel D APPLIC T ❑ CONTACT PERSON., A Fee for branch eireuits wills service or feeder fee,each 6.65 ? Business name; 01 orbranch circuit -� A Fee fbr branch tirculis _ - Contact name: whhen t servioe or feeder fee, eot.h branch circuit I 46,85 Adds res: Each add'I branch circuit 6.65 _? city/state/ZIP: Miscellaneous(service or feeder not included) - Pump or irrigation circle 53.40 2 Phone'( ) - Fax::�� ) sign or outline li rhting 53.40 2 E-mail: _ _ Signal cireuit(s)or limfted- --� - M CONTRACTOR - energy panel.alteration,or — --' extension,Describe: Pug:? 13usinmIllme:Hillsboro Electric L — Addlass21 8 5 EV @@22 p Raeh additional Inc Ion over allowable In an of the drove --�.� +g —� perinspectfon 62.50 City/StatrJZiP: Hi 11 sboro l OR. 9 712 4 Invests tion per hour(I hrmfn) 62.50 -T Industrial plant r hour 73.75 Phone:(503) 4_39-95661 Ftkx:(503 )601-3680 — – .—.— -- ELECTRICAL P$RMtT FEES" CCR LIc.,1 3 4 4 81 Electrical Lic.:3 4–4 9 9 0 Suprv.Lic. 4 9 41 S subtoul Suprv,Electrician signature,required. t Plan review(25%of permit fee) ^` Printname:Jptey Vi>laCCo � State surcharge(80A of permit fee) TOTAL PERMIT FEE Authorized signature: This permit appHeat en expires its perms,is not obtained w rhls lea — days after It has been.eesltted to complete Print name: Date: _i Fee methodolop son by Tr-County Building Indtnery 5ervore Bund "Number of insprctiay per permit ailuwe: 1Budd+ray+Pmui1,ELGPerrellApOdoc 12101 44a1615T1111M?1C0"63 CITY OF TIGARD 24-Hour BUILDING Inspection Line: (503)639-4175 MST iNSPEGZ ' DIVISION Business Line: (503)639-4171 BLIP Received __ Date Requested IS AM---PM_ _ BUP Location a� L �1 _._ Suite MEC = !, Contact Person ---- Ph (0.1) L PLM _ Contractor—___ _ —_ Ph( ) ____ SWR BUILDING Tenant/Owner __ — _ ELC Footing ELC _ Foundation Access: Ftg Drain ELR Crawl Drain Slab Inspection Notes: SIT _ Post&Beam Shear Anchors - Ext Sheath/Shear Int Sheath/Shear �- Framing Insulation Drywall Nailing -- --- -- -- Firewall Fire Sprinkler - - --- Fire Alarm Susp'd Ceiling --- - -- - Poof Other: ------ --- - -- Final _ PASS PART _ FAIL PLUMBING Post&Beam Under Slab Rough-In Water Service Sanitary Sewer Rain Drains ---- — --- Catch Basin/Manhole Storm Drain Shower Pan Other._ — ---- ----�._--- Final P PART FAIL ._-- CH est eam Rough-I Gas Line oke Da pers --- - ----- — r PASS PART FAIL - Service — Rough-In UG/Slab Low Voltage %S;ART FAIL Reinspection fee of$_. required before next inspection. Pay at City Hall, 13)25 SW Hall Blvd. SITE— — [� Please call for reinspection RE: F] Unable to Inspect-no access Fire Supply Line ADA -b cr,..""� Approach/Sidewalk Dates. �------- tae r E>Itt Other: Final DO NOT REMOVE this Inspection record from the b site. PASS PART FAIL � � t!'1 CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24-Hour Inspection Line: 639.4175 Business Line: 639-4171 - — _ BUP Date Requested_ � AM� PM _ BLD Location)?-�� / _ `,? ��! ��' C9 ��L ► S//cite MEG Contact Person — _ - _ Ph C', ,�65;10 PLM - -04Z�LyX, Contractor Ph SWR BUILDING _ 'Tenant/OwnerELC Retaining Wall ELR Footing Access: Foundation FPS Fig Drain SIGN Drain Inspection Notes^ _ - -- — Slab �—_ SIT Post& Beam —- — Ext Sheath/Shear _ Int Sheath/Shear Framing Insulation �^ Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling - - - - - - - - - - Roof Misc: --- ---- -.._ -- - - - Final �-------- --- PASS PART FAIL. C01IABiN ost& Feam -- - - Under Slab Top Out Water Service S"anitary `,rawer -- Ra�n Drains �5i, PART FAIL _ — ECNANICAL Post& Beam Rouqh In Gas Line Smoke Dampers Final PASS PART FAIT_ ELECTRICAL — Service Rough In UG/Slab Low Voltage Fire Alarm Final — --^PASS PART PART FAIL SITE Backfill/Grading — .-- Sanitary Sewer Storm Drain [ )Reinspection fee of$ required before next inspection Pay at City Hall, 13125 SW Hall Blvd Catch Basin Fire Supply Line I ) Please call for reinspection RE:_ —_ ( )Unable to inspect-no access ADA Approach/Sidewalk Date Inspector Ext Other — Final PASS PART PAIL DO NO REMOVE this inspection record from the job site. I CITY OF TIGARD BUILDING IN'SPECTION DIVISION MST 24-14our Inspec+.ion Line: 639-4175 Business Line: 639-4171 - -- --- 8UP _Date Requested 17- —_^ AM^_— __PM �____- BLD Location- Z I ^Lr<�w r� -__ Suite — MEC Contact Person __— Ph ��' PLM `-- Contractor - Ph _ X 2 SWR -- BUILDING _ Tenant/OwnerELC Retaining Wali _ -- ELR (, Footing A;cess: Foundation FPS Ftg Drain Slab Crawl Drain Inspection Notes: �.�,, SGN — o SIT Post&Beam Ext Sheath/Shear Int Sheath/Shear ---___------_----- _-�-� Framing Insulation _--- ---_--___--_- Drywall Nailing Firewall - - Fire Sprinklerge Of Fire Alarm Susp'd Ceiling Roof 7 — _ ---- Final PASS PART FAIL PLUMBING [lost& Beam Under Slab Top Out Waler Service Sanitary Sewer Rain Drains Final PASS PART FAIL MECHANICAL Post& Beam -- - ----- Ro;�ah In Gas Line Smoke Dampers Final PASS PART FAIL ELECTRICALService- Rough In ---- ------- ---- .�_ low Volta a Ire arm Fi ASS PART FAIL Backfill/Grading ---` - -- - --- Sanitary Sewer Storm Drain I j Reinspection.fee of$ -required before next inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin Fire Supply Line I j Please call for inspection RE _ ] able to Inspect-no access ADA Approach/Sidewalk Date Ins actor xt Other _ p _ Final PASS PART FAN_ 0 NOT REMOVE this inspection record from the job site. CITY OF TIGAk2 BUILDING INSPECTION DIVISION MST 24-Hour Inspection Line: 639-4175 Business Line: 639-4171 BUP Date Requested__r 3 —AM PM ' BL.D Location /Z 2- l rY 5 c,/ w L ✓1 Suite MEC Contact Person Ph - G ye-3 y PLM _ Contractor Ph SWR UILDING--�> Tenant/Owner _ EI-C ---- I-taining Wall ELF,, Footing ----_---------_ -... Access: Foundation Ff"S Fig Drain SGN Crawl Drain Inspection Notes: Slab SIT Post&Beam -_ ____-----------.._. Ext Sheath/Shear Int Sheath/Shear — Framing .'---- �� t -gyp' Xr- /-7r-rr4r.6,z.;.- Insulation Drywall Nailing _ ----------- -- — Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Misc: --- naP S PART FAIL --- -- ___ BING Post& Beam Under Slab Top Out Water SeNICE. Sanitary Sewer - Rain Drains _ Final �— PASS PA FAIL GHANIGAL Post K Beam -- -- Rough In Gas Line — — — -- Smoke Dampers 0AS PART CTRiGAL. Service _ Rough In UG/Slab r Low Voltage Fire Alar. _-- Final PASS PART FAILSITE Backfill/Grading Sanitary Sewer Storm Drain j Reinspection fee of$ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin [ j Please call for reinspection RE_ _ [ j Unable to Inspect-no access Fire Supply Line ADA Approach/Sidewalk Date �� Inspector Ext Other _ _ _-- —_- Final 1 PASS PART_ FAIL. 00 NOT REMOVE this inspection record from the job site - m rn D m v) FFI U) � � O D O Z m \ f., --� m O i Fri Z - C� C) � c C rn > 4 C y M c ' in O co r� _ 1 y D nm r —i < rn m m Rl o -Z 0 p Rj r J 1 CERTIF;CATEOFOL:CUPANLY CITY OF TIGARD PERMIT#: MST2000-0001 DEVELOPMENT SERVICES DATE ISSUED: 5/12/00 3125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 PARCEL: 23103CB-11800 ZONING: R-4.5 JURISDICTIOP: TIG SITE ADDRESS: 12218 SW HOLLOW LN SUBDIVISION: QUAIL HOLLOW - EAST BLOCK: LOT:076 `CLASS OF WORK: NEW TYPE OF USE: SF TYPE OF CONSTR: 5N OCCUPANCY GRP: R3 TENANT NAME: REMARKS: PATH I New single family dwelling w/attached garage and covered porch. Owner: DON MORISSETTE HOMES 4230 GAL.EWOOD STREET SUITE 100 LAKE OSWEGO, OR 97035 Phone: 274-5223 Contractor: DON MORISSETTE HOMES 4230 GALEWOOD STREET SUITE 100 LAKE OSWEGO, OR 97035 Phone: 503-387-7538 Reg #: LIC 00035533 This Certificate issued NO fill grants occupancy of the above referenced building or portion thereof and confirn-,s that the building has been inspected for compliance with the State of Oregon Specialty C^des for the group, occupancy, and use under which the referenced permitWas issued. 1 ' BUILDING INSPECTOR BUILDING FFICIAL POST IN CONSPICUOUS PLACE i CITY OF TIGARD 13125 S.W. HALL BLVD. TIGARD, OR 97223i�� V I MAY � g IMPORTANT PERMIT NOTICE 2000 HARRY + SON PLUMBING INC 7117 NORTH ARMOUR PORTLAND, OR 972C3 Plumbing Signature Form Permit ##: MST2000-00091 Date Issued: 051121'1000 Parcel: 25103CB-11800 Sita Address: 12219 SW HOLLOW LN Subdivision: QUAIL HOLLOW - EAST Black: L..ot: 076 Jurisdiction: URB Zoning: R-4.5 Remarks: PATH I: New single family dwelling wlattached garage and covered porch. Your company has been indicated as the plumbing contractor for the permit indicated above. In order for the plumbing permit to be valid, please. have the appropriate individual frorn your company sign below and return this Plumbing Signature Form prior to the start of the work to the address above, ATTN: Building Dept. No plumbing inspections will be authorized until this completed form is received OWNIR: PLUMBING CONTRACTOR: DON 11rIORISSETTE HOMES HARRY + SON PLUMBING INC 4230 GALEWOOD STREET 7117 NORTH ARMOUR SUITE 100 PORTLAND, OR 97203 LAKE OSWEGO OR 97035 Phone 11. 274-5U3 Phone #: Reg #: 1 it 00068900 P1 M 26-448ob AN INK SIGNATURE IS REQUIRED ON THIS FORM Signatt of Authorized Plumber If you have any (joestions, please calf (503) 639-4171, ext. # 310 FRnM : ROSS ELECTRIC FHOhE t-U. : May. 10 2000 12:37PM PS CITY OF TIGARD 13126 S.W. HALL BLVD. TIGARD, OR 97223 IMPORTANT PERMIT NOTICE ROSS ELECTRIC STEPHEN LLOYD ROSS 23810 SW DRAKE LN HILLSBORO, OR 07123 Electrical Signature form Permit ts: MST2000.00091 ate DIssued: 0311212000 Parcel: 25103CS-11800 Site Address. J2219 SW HOLLOW LN Subdivision: QUAIL HOLL GW- FAST k3lock: Jurisdiction: URB Zoning. R45 Remarks: PATH I: New single fam!ly dwelling w/attached garage and covered porch. Your company has been indicated as the electncal contractor for the permrt indicated above. In order tar the elect;icai perrnit to be valid,ttw slgr,aturq of the supervising electrician is required. Please have the appropriate Individua! from your company sign belrw and return this Electncal Signature Form prior to the start of the work to the address above,ATTK Building Dept. No electrical inspections will be authorized until this completed farm is received OW,JLR; ELLCTR1CAL CONTRACTOR-. VON MORISSETTE HOMES ROSS ELECTRIC 4230 GALEWOOD STRE -T 3I'FPHEN LLOYD ROSS _ .._ ._23u10.SW-LU1AKE-LN - - - - -:��31pp�Ep�OAyy�E- -p — - --- _ p� p LAKEone #SZ7AGOP 97035 P�otnes#642��800 67123 Req #: ELF ia.43ar uc oei I Be SUP 4232s AN INK SIGNATURE IS REJUIRED ON THIS FORM x ,,c.4�-- 7 _ Si�na'uer re of Supvising Electrician If you have ally gUentions, please call (503) 639-4171, ext. #310 ORIGINAL CITYOF TIGARD PLUMBING PERMIT DEVELOPMENT SERVICES PERMIT#: PLM2000-00206 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 6/14/00 SITE ADDRESS: 12218 SW HOLLOW LN PARCEL: 2S103CB-11800 SUBDIVISION: QUAIL HOLLOW - EAST ZONING: R-4.5 BLOCK: LOT: 076 JURISDICTION: TIG CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES: TYPE OF USE: SF WASHING MACH: BACKFLOW PREVNTRS: 1 OCCUPANCY GRP: R3 FLOOR DRAINS; TRAPS: STORIES: WATER HEATERS: CATCH BASINS: FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS: SINKS: URINALS: GREASE TRAPS: LAVATORIES: OTHER FIXTURES: TUB/SHOWERS: SEWER LINE: ft WATER CLOSETS: WATER LINE: ft DISHWASHERS: RAIN DRAIN: ft Remarks: Installation of residential hackflow device. Owner: FEES Type By Dare Amount Receipt DON MORISSETTE HOMES PRMT L'LH 6113/00 $25.00 0002941 4230 GAI.EWOOD STREET SUITE 100 5PCT DLH 6/13/00 $2.00 0002941 LAKE OSWEGO, OR 97035 Total $27.00 Phone 1: 274-5223 Contractor. PROGRASS LANDSCAPE SERVICES 29895 SW KINSMAN RD WILSONVILL.E, OP 87070 REQUIRED INSPECTIONS Phone 1: 682-6076 RP/Backflow Preventer Reg #: LIC 00006136 PLM 11558 This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable laws. All work will he done in accordance with approved plans. This permit will expire if work is riot started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION. Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-0001-0010 through OAR 952-0001-0080. You may obtain co—plies of these rules or direct questions to OUNC by calling (503) 246-1987. Issued By: ' I �` -,re--- Permittee Signature: Call (503) 639-4175 by 7:00 P.M. for an inspection needed the next business day Gt,'Ob!PO 'I'll: 10:57 FAX 503 598 1960 CITY OF TIGARD CITY or TIGARD Plumbing Permit Application Plan Cjecx1 13125 SW HALT_ BLVD. RECEIVL-C Commercia! and Residential RerdBy TIGARD, OR 97223 Da-.o Reo�y — (503) 639-4171 Dave to VE .JUN 0 7 2000 Print or Type �/ De1e it DBT �� t r Illegible a licatinns will not be accepted Permit:M S. COMMIIPfI"�9��li� 9 PP P Relates sr;R o — Called— J'— Name of DeveopmentiProjec: �{ -Sink S (Lpolril�uil). ;' e, r ye •ggam� f;- QTir - 'PRICE11,50 Job OAA-&A)- 4O1Lau2l sl.,k Address StreetAddreej.. suite lavatory— 11 bo i r}rj I i a Ll,• Tub or Tub/Shower Comb. 11.50 Bldg M CRY/Slate jJp '3ho,var Only - 11.60 T1 cl,�d b 2 Water Closer 11.50Name !�- _ 11.50 bc-n ROY % *e kDYY1C$ Dishwasher^ Owner Mail naAddress SuRe GerbageDisposat —_—_ 11.90 ya3o sw Galeruoac� Washing Machine 11.60 Gtyrs ate Zip Phone Floo'Cr^.WFfoor Sink 2' 11.60 b i LAKC OSWC Ott. 790– &9 S{n 3, – 11.50 Nance - �• 11 5D Occupant NHUing Ad a5 S lte Water Heeler O rcnverabn O if d 11.80 Cee piping re ul:es a se erste nechen cal permit Gty/51ate 7Jp Phone Laundry Room?ray 11_50 Urinal 11.60 (f-��'Kisca� CIL C�IneOiorFdapci _ --� } lid&I1$s SI -- - Contractor Mailing Address >ry 5 W /(Infmatt R _ Prk:r!o permit Gtyralate Zip Phone L Fp- sewer-tat 100' ^ 3a.00 LSSrlance,a copy tj S-d12 Utile, 02.970)U L_U7 bt0 Sewer-each additional 100 -� 3200 of all licenses are Orege Cont.Cant.Board Uc 0 ExpDa:e — 3800 required VZ _ gl-3/ )C)on Water,ervlce (:t 100, - -- expired In COT Plumbing Lit 9 _ E-V.Da'e Water SeriIce •each&MMonal 20e - 32.00 database -_L _ Storm d Raln Lkain-1st 100' 38.00 —_ -" Name Storm 3 Rain Drain-each additional 100' 32.00 Architect _ —Mab-41W—Home Space 32.00 A Or Maiing Address Suite Gcmmerclal Back Flwv Prevention DevEe or Aryl• 32 00 Pollution Device CA Zip Phone Residential Bacxflew PrPventlm rlevioe' Engineer (Irrlgatior Ilmin6 devIcas requlm a separate Gascrihe work to be citric: _ restricted energypeerrnit_) A,y Trap or W Ne-v O Repair O Rep:aca Ahh liko kind: Yee O No O aste Nol Connected to a Fixhire 11.50 Resldenllal O Commercial O s _ Catch Basin M 11.50 Additional desctlpticn of work: Insp of.b y My°Irxrrbir g 50.00 hc.1Ll) f2r-r-L,*eA 17tyy) Wil)i�� _ � - _ evhr Specially Requested Inspectlons 50.00 Areyou capping,moving or replaelrq any fixturea7 per/1r Yes 0 No 0 RRIn Dialr,single family dwelling 45.00 If yea,see back of form to indicate work performed by Grease Trups 1150 fixture. FAILURE TO ACCURATELY REPORT FIXTURE _ WORK COULD RESULT IN INCREASED SEWER FEES, CIUANTiTY TOTAL r if 7.- I hereby-_Knowledge that:have read this application,the:the information Isxrrric er ricer dap,.m is requlrad R ouan'IN Tdal is -9 _ given is correct,that I am the owner or authorized agent of the owner,and 'SUBTOTAL Val plans subml"ed are F tom dance with Cre cn State Laws. —Slycat,:rcer w crit a Eh SURCHARGE ;: �tP Contact Person Phone •'PLAN REVIEW 25°k OF SUBTOTAL Na . Rcquitt only 1t'ixure 9ty.lotal is>9 itrn w: TOTAL J _ ' 78ATNNaUSXi T8O0;�,,,r.�4� �t,�' Sr�t r•M i.�� y-ssr � �/ _...• •,y��,ra pt Residential Ba.ktow3�Ryp3Minimum perm e +5Yo surcharge,exce _$1S31T}{ppq, !32sd,R9, .+ se n�� r{ �••" _� Pre:entl4R�9'+1GR� 1'.111 35+5;1 urcftar i§lg� Efijdi$yr�tp{d +t��i' ,` ►( :_ . J + - ••111 New Commerclsi Buildings require plans wRt isometric or riser rr 3y:ain 106 frefteeritprsiviriaal�am.eevwrAntl. l4 y arrJ p@n revkw .tda7a:':rrts`alurnpD dc:4r'..'S9 O610&('99 TLT' 10:5'_+ 1,\ 503 598 1960 CITY OF TIGARD Q]003 PLEASE COMPLETE_ Fixture Type Gluantlty by Work Performed New Moved Replaced RemoyedlCapped 4Q,0,-: Sink Lavatory _ Tub or Tub/Shower Combination Shower Only _ Water Closet _ Dishwasher -ge--- GarbaDisposal_ � Washing Machine Floor Drain/Floor Sink 2"411 Water Heater Laundry Room Tray Urinal Other Fixtures (Specify) COMMENTS REGARDING ABOVE: ORIGINALELECTRICAL PERMIT- CITYOF TIGARD RESTRICTED ENERGY DEVELOPMENT SERVICES PERMIT#: ELR2000-00141 13125 SW Hall Blvd.,Tiqard, OR 97223 (503) 639-4171 DATE ISSUED: 6/14/00 SITE ADDRESS: 12218 SW HOLLOW LN PARCEL: 2S103CB-11800 SUBDIVISION: QUAIL HOLLOW - EAST ZONING: R-4.5 BLOCK: LOT: 076 JURISDICTION: TIG Project Description: Installation of irrigation controller. A. RESIDENTIAL B.COMMERCIAL AUDIO & STEREO: AUDIO & STEREO: INTERCOM & PAGING: BURGLAR ALARM: BOILER: LANDSCAPE/IRRIGAT. GARAGE OPENER: CLOCK: MEDICAL: HVAC: DATA/TELE COMM: NURSE CALLS: VACUUM SYSTEM: FIRE ALARM: OUTDOOR LANDSC LITE: OTHER: IRRIGATION : X HVAC: PROTECTIVE SIGNAL: INSTRUMENTATION: OTHER: TOTAL#OF SYSTEMS: Owner: Contractor: DON MORISSE'TTE HOMES PROGRASS LANDSCAPE SERVICES 42.30 GALEWOOD STREET 29895 SW KINSMAN RD SUITE 100 WIL.SONVILL.E, OR 97070 LAKE OSWEGO, OR 97035 Phone: 274-5223 Phone: 682-6076 Reg #: LIC 6136 FEES Required Inspections Type By Date Amount Receipt Low Voltage Inspection PRMT DLH 6/13/00 $60.00 0002941 5PCT DLH 6/13/00 $4.80 0002941 Total $64.80 This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION. Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAP, 952-001-0080 You may obtain copies of these rules or direct questions to OUNC at (503) 246-1987. Issued by ,u _ Permittee Signature OWNER INSTALLATION ONLY The instal!3tion is being made on property I own which is not intended for sale. lease, or rent. OWNER'S SIGNATURE: DATE: CONTRACTOR INSTALLATION ONLY SIGNATURE OF SUPR. EL.EC'N _ DATE:------------- LICENSE ATE: _--__—_ _ _- LICENSE NO: Call 639-4175 by 7:00 P.M. for an inspection needed the next business day 06/08%99 TLE 10:59 FAX 603 098 1960 (;111 Ur 11"AAD .,,--• CITY OF TIGARDRECEIVED RESTRICTED ENERGY ELECTRICAL APPLICATION Recd by: 111f 131251W HALL BLVD Date Recd: YIGARD OR 9TA 7 MPP PRINT OR TYPE V-503-09-4171 A4 Permit illi: F -503-598�g�p INCOMPLETE OR ILLEGIBLE APPLICATIONS Cust.Call'd: I;tIM1�lUNItV UEVELI)('Mt Iv i WILL NOT BE ACCEPTED Name cf Development Project TYPE OF WORK INVOLVED-RESIDENTIAL-ONLYI 4 7 Reitrlcted Energy F........_.................. ..... . $60.0D f,iu Ct�e� �{ILTw (FOR ALL.SYMMS) JOB ADDRESS I" +`i S I-t0 II o1�t_ cwt,,e_ Check Type of Wcrk Irnrolved: �^ 4ly/3tate Ztp hones ❑ Audio and Stereo Systems I < r.r rcl (,r12 ci' T' :J. Na — ❑ 8urg1arA!arm D o-r-i M n s S vfk. Horn es Add ❑ oarage Dour Opener OWNER Lil ass old D to& f eAk) ej0 L �1�"_ n Healing,venylatinn and Air Conditioning System*, , Vtate Do Phone 6 G�tx� q7 U3 4 ?90-Grp (� ❑ vacuum system• lime t_urill scsyC 1�m&' o. ItLtutc_'COLP e, Other �wi�scc,�� -t•1� 4#ian Ce»tn�ll� CONTRACTOR 'a!i `' a Rtu ktns TYPE OF WORK INVOLVED-COMMERCIAL ONLY (Prior to issuance a City/State Zio Phone h Fee oreech system...................................... - 80.00 COPY of all licenses W t 1 ym U1l1 C, J oR.q-jol o to to-60 441 (SEE OAR 916.260.260) are required)f Oregon Cgntr.I rd Loc.0 F 3 ate all expired in C O.T. �� _ Check Type of Work Involved. data base). Electrical Con V.Lic.p Exp Oate Audio and Stereo Systems C O.T.or More Lk:.0--'^� xp• ate ❑ 8o+tor Coctrcls clock.Systen OWNER Mailing Address APPLICANT ❑ Dete Telecommunication Installation . Cityrilate — Zip I Phone 11 ❑ Fire Alarm Installation Thi,permit Is Issued under OAE 918.32C-370 This applicant agrees to L� HVAC make only restricted energy Installations if 00 volt amps or less)under this permit and to do tete following ❑ Instrumentatlon t. Only use electrical iicensed persons to do lnstaliallons where required Certain residential and other transactions are nxempt from licensing. E] Intercom and Paging Systems These have astei;slcs(•) All others need licensing; ❑ Landscape In,gation control- 2. Call fo.,inspections when Installation t.ntler inis permit are ready for Inspection at 603.639.4176; L-] Medical a. Purchase seperate permits for ell installations that are not ready for an F-1 Nurse Calls inspection when the inspector is out to lnapect under this perntit, a Assume responsibility for assuring that all corrections required by Iho ❑ Outdoor Landscape L' hJng' Insxdor are done and; ❑ Protecttve Slpna!irtg Assume resoonsini ity for calling for a final lnspeotion wh,n all of the corrections are completed. ❑ Other Per-nits are ncn Iransferrb.s and non-refundable and exp ie if work is not started with n 180 days o'issuance or if wee*.Is suspended for 180 days __ —Number of Syctens The person signing for this permit must be the applicant or a person • No licenses are equlred 'icenses are requIred for ell over ln!WlaLans euthofted to bind the app' nt - --- ----- -- _ FEES: ENTER FEES s Signature j-x"' q eo L SURCHARGE Lbs X TJ1Ai_ABOVE) S �p b Authority If other than Applicant TOTAL S_ bo_(____� C'�sts�rorn svestie doc ecce CITY OF TIGARD MASTER#: MSTT PERMIT#: 5T2000-00091 DEVELOPMENT SERVICES DATE ISSUED: 05/12/2000 13125 SW Hall Blvd.,Tigard, OR 97223 (503) 639-4,171 SITE ADDRESS: 1221JSW HOLLOW LN PARCEL: 2S103CB-11800 SUBDIVISION: QUAIL HOLLOW - EAST ZONING: R-4.5 BLOCK: LOT: 076 .JURISDICTION: URB REMARKS: PATH I: New single family dwelling w/attached garage and covered porch. BUILDING _ REISSUE STORIES. FLOOR AREAS REQUIRED SETBACKS REQUIRED _ CLASS OF WORK: NEW HEIGHT. FIRST: 917 sf BASEMENT: O.OU st LEFT. I' SMOKE DETECTORS. i 7YPF OF USE: SF FLOOR LOADSECOND: 1,086 sl GARAGE: 440 ■f FRONT: P,''KING SPACES: TYPE OF CONST: 5N DWELLING UNITS: I FINBSMENT- 0 St RIGHT. 5 VALUE; S 181.292.27 OCCUPANCY IRP: R3 BDRM. I BATH: 3 TOTAL: 2,00300 sl REAR. .1 PLUMBING SINKS: 1 WATER CLOSETS: 3 WASHING MACH LAUNDRY TRAYS: RAIN DRAIN to TRAPS. LAVATOWES'. DISHWASHERS. FLOOR DRAINS: SEWER LINES: 100 SF RAIN DRAINS I CATCH BASINS: TUBISHOWLCS: GARBAGE DISP: I WATER HEATERS: I WATER LINES: 100 BCKFLW PREVNTR GREASE TRAPS. OTHER FIXTURES. MECHANICAL FUEL.TYPES FURN c 100K: BOILICMP<3HP. VENT FANS. •I CLOTHES DRYER. FURN>=100K: I UNIT HEATERS: HOODS: I OTHER UNITS: MAX INP. btu FLOOR FURNANCES: VENTS: WOO:,STOVES-. GAS OUTLETS. - ELECTRICAL RESIDENTIAL UNIT _ SERVICE FEEDER TEMP SRVWFEEDERS BRANCH CIRCUITS MISCELLANEOUS_ ADD'L INSPECTIONS 1000 SF OR LESS: 1 0 - 200 amp: 0 - 200 amp: WISVC OR FOR: 1 PUMPIIRRIGATION PER INFPEC110N: EA ADD'L 500SF. 1 201 - 400 amp•. 201 400 amp let W/O SVCIFDR: 00 SIGNIOUT LIN LT: PER HOUR: LIMITED ENERGY: 401 - 600 amp: 401 600 ampEA ADDL OR(IR: SIGNALIPANEL. IN PLANT MANU HMISVCIFDR: 601 1000 amp: 601-amps-1000v. MINOR LABEL 1000.amplvolt: _ PI 0.11 REVIEW SECTION _ Reconnect only: >=4 RES UNITS. SVCIF DR>=225 A >Bbb J NOMINAL, CLS AREA)SPC OCC. ELECTRICAL•RESTRICTED ENERGY A.SF RESIDENTIAL 8.COMMERCIAL AUDIO 8 STEREO. VACUUM SYSTEM: AUDIO 6 STEREO. FIRE ALARM INTERCOM/PAGING. OUTDOOR LNDSC Lr BURGLAR ALARM: 0TH: BOILER: HVAC LANDSCAPEIIRRIG PROTECTIVE SIGNL: GARAGE OPENER: CLOCK: INSTRUMENTATION. MEDICAL. OTHR: HVAC. DATAITELE COMM: NURSE CALLS. TOTAL 0 SYSTEMS. Contractor: TOTAL FEES: $ 4,360.2.0 Owner: This permit is subject to the regulations contained it) the DON MORISSETTE HOMES DON MORISSE rTE HOMES Tigard Municipal Code State of OR Specialty Codes and 4230 GALEWOOD STREET 4230 GALEWOOD STREET all other applicable laws All work will be done in SUITE 100 SUITE 100 accordance with approved plans This permit will expire if LAKE OSWEGO.OR 97035 LAKE OSWEGO,OR 97035 work is not started within 180 days of issuance or if the work is suspended for more than 180 days ATTENTION Phone: Phone. Oregon law requires you to follow I Liles adopted by the Oregon Utility Notification Center Those rules are set Rena LIC 00035513 forth in OAR 952-001-0010 through 952-001.0080 You ORIGINAL may obtain copies of these ules or direct questions to CLING by calling(503)246-1987 REQUIRED INSPECTIONS Erosion 844-8444 Post/Beam Mechanical Mechanical Insp Shear Wall Insp Rain drain Insp Mechanical Final Sewsr Inspection Underfloor insulation Plumb Top Out Low Voltage Water Line Insp Plumb Final Footing Insp Crawl Drain/Backwater Electrical Service Gas Line Insp Appr/Sdwlk Insp Final inspection Foundation Insp Footing/Foundation Dr; Electrical Rough In Gas Fireplace Urb St Tree Certif Ltr F Building Final Post/Beam Structural PLM/Underfloor Framing Insp Insulation Insp Electrical Final Issued By : Permittee Siqnature . — \ 1 'LL4—,L,( Call (503) 639-4.15 by 7:00 p.m. for an inspection needed :he next business day CITY OF TIGARD Residential Building Permit Application Plan Check# 13125-5W HALL BLVD. Additions or Alterations Recd By�_ Date Recd 3 1-6) TIGARD, OR 97223 Single Family Detached or Attached (Duplex) Date to PE4-- V 503-639-4171 Date to DST_3 �'ry F 503-684••7297 C Permit Print or Type J//'�C Called D17)U Incomplete or illegible applications will not be accepted Name of Prole — � a Name Oa_ � 1�` �, , Job 111„ kONV t �,,' a�linoAddressII1 s~.GlIVY- Address SiAdd s Architect _ _ �t� � ci; lame e ity/S a ip. Phnnp NameOwner I nihnn n,in,Pcs Ji;11) (7�Ct'I�bvr6 �' #�a) Engineer Marling Address — h f, City/State --- tip Phone -� General Name Contractor E F1 Describe work New Addition O Alteration O Repair O Madinq Address to be done Prior to permit Additional Description of Work: * Ip ,Vr issuance,a copy rty/St to Zip hr one I _ �ti of all licenses �� _ are required if Oregon Cbnst.Cont. Board E p D ►e� PROJECT 2 expired in COT Lic# �C•�J3 _ ? I10) VALUATION $_ database _ Mechanical Name _- NEW CONSTRUCTION ONLY: - Sub- (� Sq Ft. House :�� Sq. Ft. Garage Contractor Mailing Address _— _.._ Prior to permit j f Gj eo Indicate the restricted energy installation by the electrical issuance a copy Phe subcontractor in the followin areas_ it rSt e �ip o of all licenses ' -31 Restricted Audio/Stereo are required it Oregon Gonst Cont Board Exp Date Energy _ System Alarms expired in COT Lic# Installations Vacuum Irrigation _database -7 -;L(o�?3 Q-\ System _ 5 stem Plumbing Name �+ (check all that Other Sub- �VLYY `. ` � �lurnbirr apply) -- - — Contractor Mailing Address Corner Lot YES I Flag Lot YES {dq (check one) i (check one) �( ._ 1:z- Has the Subdivision Plat recorded'? NIA 1(F,S NO Prior to permit Z Phone issuance,a copy , ; -- -- --�--”of all licenses are q%rist'Cont Board Exp Dat required if Lic# C1 - expired in COT �L �.t_� f I I hearby acknowledge that I have read this application, that the database Plumbing Lc # Exp Date information given is correct,that I am the owner or authorized agent ;�t>' - of the owner, and that plans submitted are in compliance with O on State laws _ Name mm S na a of caner/ gent -0ate, Electrical f• � L �Yl v� �— �'�- 5` Sub- Mailing Address act Person Na �e Pftpne# Contractor 9 Z I G City/State Zip Phone Prior to pennit issuanc,a,a copy T711C�_ 8 1 FOR OFFICE USE ONLY: of all licenses are Or- an Const Cont. Board Exp Date Plat# Ma ITL#' required if Lic# expired in COT (.i LE I t � I ` 1 00 pJ database ect`ical LiG # / F D to I Se cks: Zona5 rl ,t..1.1tL �� ---� Electrical Supervisor l-.c # _ Ibj D�t� I c�gine g Approval Planning Approval: -- - -- — - V I L_l 1` --- j - G*a i\dsts\fnmts\sfaddalt doc 11/20/98 OBE : 031 DON MORISSETTE � 4 s 360 G A L s w O o D a Ra T R aTs T LOT: 79 Lets 08f = a0, 0 B I a a x 9 7 a a a DATE: 3/18/2000 (603) i67 - 76 3 6 fez (603) 667 - 7616 PROPERTY: QUAIL-HOLLOW CITY': TIGARD SCALD: 1"=20' STANDARD ELEVATION PLAN No.: 711 122 113 S-WI HOLLOW .ANE APproach 5 0 atdewa Ik 299 Zee �r r i1 Gcmcrete ro- 9.„ � 29 Driveway ----•�. __ 3m�` - ^i+ � !1'-O' `aha 440 6q. ft. ►"� 2 car gar. �zF.FE. 301' rb' i 3 C2' I I 2 jdm3 eq. Ft. , 0 2 1/2 bath FF.=-. 304' Ln I 14' I — g' o• 303 4, D' 302 ID. 4 1 I - � 10'x10' I I I 6dfC. I pato I I I I I I � I I s I 304 50.001 302 LOT x''16 5,25metj. ft. unif led SANITARY* 0 0 sewerage Uf155 a enc N. First Ave.. Suite 270, Hill b to, Or.,97124 SURFACE WATER I 503 648-8621 CONNECT TON ISSUE I:IA'TC: 042100 EXPTRATION PATE 101800 FC EXP DATE 049"10:' PERMIt 11865k, STRUCTURE ADDRESS 12219 PPO„IF:f:'T 9g>07 STRUCTURE STREET SW HOL.I_UW I-N L.OT 76 [LUCK TYPE CONN'r.�C'TION•- NEW OF CTI.IATt- H(li_.LOW F=AF3T 1 '(PE INSTAI-L.ATION - ( 19 ) T+I_I) 3WR/E:RO CON/ST.IC TYPE OCCUPANCY— ( 1 ) SINGI.F FAMILY PARCEL. 251 3CI:I 1.1800 01'1 $1-(, 4417 MH 2(,4950 OWNER DON f'IC1Fkr .isu TE Hi. m:s APPRE.S5 4'230 SW GAL E WOOD TRF ATMF..NT PI_AN1" 011RHAM LAKE OSWEGO OR 97035 I'HONE 3E17--7538 WATEk DISTRICT T16ARL1 FIXTURE ALE:NT 11WE1, L.INf1 RESIDENTIAL. LINTI'S f)EIRVIC: ' 1.IN71'S 0 ►0 UNITS 1 SFRVICE CONNECTION FEES SUPFACF' WATER T:IFVF'L.0PV1 :N1 F-T S SEWER CIJNNKCT'T()N 300.00 WATER 0UAI. I T Y 111:10 .00 L.ES4.; CREDIT ;'.10.00:. WATER PLIANT;i'Y 290.00 LESS CRE:IIII r. 0 . 00.* EROSIGN CONTROL. INSPECTION 64.00 PLAN CHF(:K 41 .60 S',.1 P.10 T AI- 2300. 00 SLIHTO ToL. 395. 60 TOTAI. 2695,60 AF'PL. NAME'. DENA PHONE: _......_ _ _.._....._ AFFIL_L..IAlION RFT' REMARKS 1_.13T 76 PPOJ 8207 (1UAI1_ HOL..L.OW EAST *24 HOUR NOTICE FOR EI'tnSCON CONT 011— INSPECTIONS REQUIPFD ** N."Ifil to call for 'EC TUN--8ASI--43444 ANDERSON' Permlt Conditions. The applicant agrees to comply with all rules and regulations of the Unified Sewerage Agency,including those regarding erosion control. A 24-hour notice is required for erosion control Inspections.The Inspection request number Is 844-8444.When calling for an Inspection,please refer to the permit,project and lot numbers. I tie permit expires one hundred eighty(180)days from the date of issuance.The Agency does riot guarantee the accuracy of the location of side sewer lateral. 7193 WHITE - USA, BLUE - Accountiny, GREEN -Inspection, YELLOW - Customer I NSFFcl`F 0 fly DATE r.�rw wr.4-ww4..iw.....r..--r..n...�..nr ..rL.r1..-... ..a.+d.b.nr+.._-.... ....+......._.- u_...._...4.._, ._.._.r.�..�.w.-......r�..�. .. i,')NlRA? I )P/INVIALIF.R y1)1 01 P111 171 AW1kk OF 1)1f•,1. Inspector , fllci..se ck(;t:jh t)e1l0w (Ir atti0l the tollpwing information: I tr',�Pt nearest cro. ,s strpot 1 'JrdtiO Ot ltruct:uro bvinq s,rvcd Noutt:� ;.if s!'rvices fr(iirt to pritperLy 1fate where it 10101+:1C:t:¢;: -!tI tJ)"1 "t;"r"VicPP IItCraI . lnc1ude length &' didmeter of <',~t-vice line, depth at i;►iv Structure. & property line- , df n(,,'nsirw.!, r?xferoncinig !in(, to structure, property lint—, and/Ur riirnEr'S, etc. North urri7w 1 I i I CITY OF TIGARD Shaping A Better Community MEMORANDUM CITY OF TIGARD 13125 SW Hall Blvd. Tigard, OR 97223 Phone 503-639-4171 Fax: 503-684-7297 TO: Distribution List FROM Kit Church DAT E 05/2.2/00 SUBJECT Address Correction Otlail I follow -- East Lot #76 Previous Address NEW Address 12219 SW Hollow Ln 12218 SW Ilollow Ln ll'you have any questions please call me at 503/639-6556 077.